FOOD ALLERGY/COW’S MILK PROTEIN ALLERGY IN NEWBORNS AND EARLY CHILDHOOD ANDTHE RESPONSIBILITIES OF THE NURSE/THE MIDWIFE

Öz

Some foods in the diet of the babies are allergen and these allergens play part in the development of some allergic diseases that can influence whole life. First food antigen encountered by the babies is mostly cow’s milk. Cow’s milk protein allergy is deŞned as the abnormal immunological response to the cow’s milk antigens. In our country, early initiation and widespread using of cow’s milk and supplementary food containing cow’s milk may be one of reasons increasing risk of allergic disease. Nurses and midwives have responsibilities such as identifying the babies at the risk of allergic disease as early as possible, taking protective measures, early diagnosis of disease symptoms and referring them, initiating and maintaining appropriate treatment and care. In this article, the prevention, early diagnosis and management of cow’s milk protein allergy which is thought responsible to come out allergic diseases in large proportion and nurses and midwives whose have important responsibilities in this subject, their roles are discussed

Anahtar Kelimeler

• Food allergy,cow’s milk protein allergy,nurse/midwife,preventive care

YENİDOĞAN VE ERKEN ÇOCUKLUK DÖNEMLERİNDE BESİN ALERJİSİ/İNEK SÜTÜ PROTEİN ALERJİSİ VE HEMŞİRE/EBENİN SORUMLULUKLARI

Öz

Bebeklerin diyetinde bulunan bazı besinler alerjendir ve bu alerjenler bütün yaşamı etkileyebilecek, bazı alerjik hastalıkların gelişmesinde rol oynamaktadır. Bebeklerin çoğunun, ilk karşılaştıkları besin antijeni inek sütüdür. İnek sütü proteini alerjisi, inek sütü antijenlerine karşı gelişen anormal immünolojik yanıt olarak tanımlanmaktadır. Ülkemizde bebeklere inek sütünün ve inek sütü içeren ek besinlerin erken başlanması ve yaygın bir şekilde kullanılması, alerjik hastalık riskinin artma nedenlerinden biri olabilir. Hemşire ve ebelerin alerjik hastalık riski bulunan bebekleri mümkün olan en erken dönemde belirleme, koruyucu önlemleri alma, hastalık belirtilerini erken tanılama, sevk etme, uygun tedavi ve bakımın başlanmasında ve sürdürülmesinde önemli sorumlulukları vardır. Bu yazıda alerjik hastalıkların ortaya çıkmasında, büyük oranda etkili olduğu düşünülen inek sütü protein alerjisinin önlenmesi, erken tanısı, tedavisi ve bu konuda önemli sorumlulukları bulunan hemşire ve ebelerin rolü tartışılmaktadır

Anahtar Kelimeler

• Besin alerjisi,İnek sütü protein alerjisi,hemşire/ebe,koruyucu bakım

Kaynakça

1. Arvola, T., Hvitfelt-Koskelainen, J., Eriksson, U.-M., Tahvanainen, A., Isolauri, E. (2000)
2. Breastfeeding and Allergy Counselling: Theory and practice. Acta Paediatr, 89:365-374.
3. Blecker, U. (1997) Role of Hydrolyzed Formulas in Nutritinal Allergy Prevention in Infants. Southern Medical Journal, 90(12): 1170- 1175.
4. Chandra, R.K. (1998) Five-Year Follow up of High-Risk Infants with Family History of Allergy Exculusively Breast-Fed or Fed Partial Whey Hidrolysate Soy and Coventional Cow’s Milk Formulas. Nutrition Research, 18(8): 1395-1411.
5. Davidson, M. (2001) When to Recognize That Breasfeeding Is Not An Option. Pediatric Nursing, 27(1): 49.
6. De Boissieu, D., Dupont, C. (2002) Allergy to Extensively Hyrolyzed Cow’s Milk Proteins in Infants Afety and Duration of Amino acidBased Formula. Journal of Pediatr, 141:271- 273.
7. De Boissieu, D., Waguet, J.C., Dupont, C. (2003) The Atopy Patch Test for Detection of Cow’s Milk Allergy with Digestive Symptoms. Journal of Pediatr, 142: 203-205.
8. Endres, W. (2000) Prevention of Food Allergy in Infants and Children. Ann. Nutr. Metab, 44: 183-186.

9. Exl, B-M., Fritsche, R. (2001) Cow’s Milk Protein Allergy and Possible Means for Its Prevention. Nutrition, 17(7/8): 642-651.
10. Gilbert, P. (1998) Common Feeding Problems in Babies and Children:2. Professional Care of Mother & Child, 8(3): 63-66.
11. Goldman, A.S. (1999) Association of Atopic Diseases with Breast-Feeding: Food Allergens, Fatty Acids, and Evolution. Journal of Pediatr, 134:5-7.
12. Halken, S. (1997) Prevention of Food Allergy. Environmental Toxicology and Pharmacology, 4: 149-156.
13. Hanson, L. (1999) Human Milk and Host Defence: Immediate and Long-Term Effects. Acta Paediatr, 88: 42-46.
14. Heinig, M.J. (2001) Host Defense Benefits of Breastfeeding For The Infant: Effect of Breastfeeding Duration and Exclusivity. Pediatric Clinics of North America, 48(1): 105-121.
15. Isolauri, E. (1997) Cow’s Milk Allergy. Enviromental Toxicology and Pharmacology, 4(1-2): 137-141.
16. Jörvinen, K.-M., Beyer, K., Vila, L., Chatchatee, P., Busse, P.J., Sampson, H.A. (2002) B-Cell Epitopes As A Screening Instrument for Persistent Cow’s Milk Allergy. J. Allergy Clin. Immunol., 110: 293-297.
17. Kalach, N., Rocchiccioli, F., de Boissieu, D., Beenhamou, P.-H., Dupont, C. (2001) Intestinal Permeability in Children: Variation with Age and Reliability in The Diagnosis of Cow’s Milk Allergy. Acta Paediatr, 90:499-504.
18. Kalaycı, Ö. (1997) Allerjik Rinit İmmünopatalojisi. Katkı Pediatri Dergisi, 18(6):671-679.
19. Klemola, T., Vanto, T., Junturon-Backman, K., Kalimo, K., Korpela, K., Varjonen, E. (2002)
20. Allergy to Soy Formula and to Extensively Hydrolyzed Why Formula in Infants with Cow’s Milk Allegy. A Prospective, Randomized Study with a Fallow-up to The Age of 2 Years. J Pediatr, 140: 219-224.
21. Kuyucu, S., Kalaycı, Ö. (1997) Bronşial Astma İmmünopatalojisi. Katkı Pediatri Dergisi, 18(6): 697-704.
22. Lowdermilk, D.L., Perry, S., Bobak, I. (2000) Maternity&Women’s Health Care. 7. Baskı, Mosby, St. Louis, 762-763.785.
23. Madsen, C. (1997) Prevalence of Food Allerg / Intolarence in Europe. Enviromental Toxicology and Pharmacology, 4: 163-167.
24. Michaelsen, K.F. (2000) Cow’s Milk in Complementary Feeding. Pediatrics, 106(suppl): 1302-1303.
25. Oddy, W.H., de Klerk, N.H., Sly, P.D., Holt, P.G. (2002) The Effects of Respiratory Infections, Atopy, and Breastfeeding on Childhood Asthma. Eur. Respir. Journal, 19: 899-905.
26. Peat, J.K., Allen, J., Oddy, W. (1999) Beyond Breast-Feeding. Journal of Allergy Clinical Immunology, 104(3):526-529.
27. Porch,M.C., Shahane, A.D., Leiva, L.E., Elston, R.C., Sorensen, R.U. (1998) Influence of Breast Milk, Soy or two Hydrolyzed Formulas on The Development of Allergic Manifestation in Infants at Risk. Nutrition Research, 8: 1413-1424.
28. Renz, H., Herz, U. (2002) The Bidirectional Capacity of Bacterial Antigens to Modulate Allergy and Asthma. Eur. Respir. Journal, 19: 158-171.
29. Scicherer, S.H. (2000) Determinats of Systemic Manifestation of Food Allergy. Journal of Allergy Clinical Immunology, 106: 251-257.
30. Scicherer, S.H., Noone, S.A., Koerner, C.B., Christie, L., Burks, W., Sampson, H.A. (2001) Hypoallergenicity and Efficacy of an Amino acid-Based Formula in Children with Cow’s Milk and Multiple Food Hypersensitivities. Journal of Pediatr, 138: 688-693.
31. Simpson,K.R., Creehan, P.A. (2001) Perinatal Nursing, 2. Baskı, Lippincott, Philadelphia, 568-569.
32. Schade, R.P., Van Ieperen-Van Dijk, A.G., Versluis, C., Van Reijsen, F.C., Kimpen, J.C.L., Bruijnzeel-Koomen, C.A.F.M., Knol, E.F. (2002) Cell-Surface Expression of CD25, CD26 and CD30 By Allergen-Specific T Cell is Intrinsically Different in Cow’s Milk Allergy. J Allergy Clin Immunol, 109: 357-362.
33. Tigges, B.B. (1997) Infant Formulas: Practical Answers for Common Questions. The Nurse Practitioner, 22(8): 70-82.
34. Vandenplas, Y. (1998) Myths and Facts about Breastfeeding: Does It Prevent Later Atopic Disease? Nutrition Research, 18(8): 1373- 1387.
35. Wilson, N.W., Hamburger, R.N. (1988) Allergy to Cow’s Milk in the First Year of Life and Its Prevention. Annals of Allergy, 61: 323-327.
36. Vinther, T., Helsing, E. (1997) Breastfeeding: How to Support Success. WHO Regional Office for Europe, Copenhagen, 39.
37. Wright, A.L., Sherrill, D., Holberg, C.J., Halonen, M., Martinez, F.D. (1999) Breast-Feeding, Maternal Ige, Total Serum Ige in Childhood. Journal of Allergy Clinical Immunology, 104(3):589-94.
38. Zeiger, R.S. (2000) Dietary a Aspects of Food Allergy Prevention in Infants and Children. Journal of Pediatr Gasroenterol Nutr., 30(suppl 1): 77-86.